Conducting quantitative mask fit tests: application details and affecting factors

Abstract

IntroductionRespirators chosen based on their assigned protection factor (APF) enable wearers to effectively reduce particulate matter concentrations to safe levels when used correctly. As a crucial factor in achieving the intended APF, the fit test has become a necessary procedure in respiratory disease protection.MethodsThis study involved 225 participants who underwent a fit test using two reusable types of half masks and two types of full masks. Condensation nuclei counting (CNC) and controlled negative pressure (CNP) were performed.ResultsThe results revealed that the passing rate of full masks was higher compared to half masks. Specifically, the passing rate for the half masks and the full masks were 84.7 and 91.6%, respectively. Gender exerted a statistically significant effect on the passing rate. Nevertheless, age, educational background, and training exhibited relatively negligible effects. Certain movements, such as facing forward, were identified as key actions with strong correlation. Additionally, talking was considered a key action with a high failure rate due to instantaneous leakages. Most participants failed at the initial step of CNP, but nearly all of them passed the fit test using CNC.DiscussionTherefore, putting on full masks, especially for women, provides optimal protection during work. Furthermore, attention should be given to the displacement and deformation of the respirator during the key actions. When it comes to fit test methods, CNC was found to be more practical and comprehensive compared to CNP. Moreover, additional physiological characteristics, such as double chins, could be explored as potential influential factors.

A systematic review of passing fit testing of the masks and respirators used during the COVID-19 pandemic: Part 1-quantitative fit test procedures

“…Xu et al assessed the fit testing results of TSI PortaCount model 8038 compared to those QHD Quantifit tester. Surprisingly, there was a significant difference between the CNC and CNP results with respect to facing forward, bending over, shaking the head, wearing the mask again, and moving the head up and down [ 45 ]. It is evident that the CNC protocol-based TSI PortaCount fit tester is the best known and most commonly used by researchers compared to the remaining fit test protocols and fit testers.…”

“…Subjects of 60 studies were HCWs, the professional group’ HCWs were included the following: four studies: anaesthetists and predominantly anaesthetic technicians, anaesthetic consultants and trainees [ 5 , 35 , 63 , 64 ], five studies: physicians [ 65 – 69 ], one study: respiratory therapist [ 66 ], twenty-one: nurses [ 37 , 40 , 41 , 59 , 66 , 67 , 69 – 83 ], one study: administration [ 84 ], four studies: allied health staff [ 40 , 59 , 80 , 84 ], seven studies: medical or clinical staff [ 59 , 73 , 80 , 82 , 84 – 86 ], one study: paramedic staff [ 78 ], three studies: medical practitioner [ 40 , 80 , 83 ], one study: aged care or disability worker [ 40 ], two studies: medical imaging staff [ 40 , 80 ], five studies: other healthcare worker [ 40 , 59 , 78 – 80 ], five studies: non-clinical role [ 40 , 80 , 81 , 83 , 86 ], one study: infection control practitioners [ 87 ], two studies: laboratory workers [ 45 , 88 ], eight studies: doctors [ 41 , …”

“…One study was conducted on one patient [ 98 ]. The study by Xu et al was conducted on chemical plant operators and maintenance personnel [ 45 ].…”

“…This happened because the fit test exercises revealed a variation in fit [ 77 ]. The fit test was not passed by talking exercise in the research by Xu et al [ 45 ] and Kechli et al [ 60 ]. The fit test exercises had a greater FF than resting exercises, according to the Baba et al study [ 104 ].…”

“…Ten studies were conducted on the impact of fit test exercise type on fitting characteristics [45,60,71,77,79,104,127,[135][136][137]. Amongst, three studies evaluated chest compression [71,79,135].…”